Acquisition. 3. Acquiring newly-constructed housing or acquiring an interest in the construction of new housing.

Section IV ELIGIBLE ACTIVITIES Acquisition Acquisition in whole or in part by the subrecipient, or other public or private nonprofit entity, by purchase, long-term lease, donation, or otherwise, of real property (including air rights, water rights, rights-of-way, easements, and other interests therein) for any eligible public purpose. In order to be considered acquisition, a permanent interest in the property must be obtained. Long-term leases only qualify as acquisition if they are for 15 years or more. Acquisition of real property is subject to 570.606 Displacement, Relocation, Acquisition, and Replacement of Housing. Additionally, acquisition of real property is subject to the requirements under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (URA) (42 U.S.C. 4601-4655). Real property acquisition does not include: 1. The costs of movable equipment, furnishings, or machinery. 2. A land write-down in which land is purchased at one price and then sold to the same entity at a lower price. This is not an eligible activity since it does not constitute a bona fide acquisition. 3. Acquiring newly-constructed housing or acquiring an interest in the construction of new housing. Application Submission Information 1. Project Description a. Provide a detailed description of the real property to be acquired. Include in this discussion a description of any existing buildings and site improvements. b. Indicate the present zoning and land use of the real property to be acquired. Indicate whether the activity will result in a change in use of the real property. c. Describe the intended reuse of the property subsequent to its acquisition. 2. Project Location a. Identify the exact geographic location of the real property. Indicate property address and nearest intersecting street. Indicate in what census tract and block group the activity is located. Provide a map indicating the exact location of the project. b. Indicate if the real property is located in or will have any impact on the following: (i) National Register Historic District (ii) 100 Year Floodplain (iii) Designated Wetlands Area c. Discuss how the proposed activity relates to any long-range acquisition program, and what the objectives of the program are. 3. Project Benefit a. Describe the existing problems or conditions to be corrected by the proposed activity. Section IV ELIGIBLE ACTIVITIES Page 4-1

b. Identify the persons affected by these conditions. c. Discuss how the proposed activity will correct these conditions. OTHER PROGRAM REQUIREMENTS - Please note, these requirements need to be addressed if the acquisition activity is funded. See Section VII for complete details. 570.503 (b)(8) Reversion of Assets. 570.504 Program Income 570.505 Use of Real Property 570.602 Section 109 of the Act. --Non-discrimination 570.603 Labor Standards 570.604 Environmental Standards 570.605 National Flood Insurance Program 570.606 Displacement, relocation, acquisition, and replacement of housing 570.607 Employment and Contracting Opportunities 570.609 Use of Debarred, Suspended or Ineligible Contractors or Subrecipients 570.611 Conflict of Interest NOTE: The Office of Housing and Community Development has as its primary goal the provision of safe, affordable housing. For this reason, our program will not consider projects that will incur relocation costs as a result of displacement of persons from housing units.. Section IV ELIGIBLE ACTIVITIES Page 4-2

Section IV ELIGIBLE ACTIVITIES Public Improvements Acquisition, construction, reconstruction, rehabilitation or installation of public facilities and improvements, except as provided in 570.207 Ineligible Activities, carried out by a public or private nonprofit entity. Public improvements include but are not limited to: streets, curbs, sidewalks, storm drainage, sanitary sewers, parks and recreation facilities, community centers, and libraries. In undertaking such activities, design features and improvements which promote energy efficiency may be included. Such activities may also include the execution of architectural design features, and similar treatments intended to enhance the aesthetic quality of facilities and improvements receiving CDBG assistance, such as decorative pavements, railings, sculptures, pools of water and fountains, and other works of art. In certain cases, nonprofit entities and subrecipients may acquire title to public facilities. When such facilities are owned by nonprofit entities or subrecipients, they shall be operated so as to be open for use by the general public during all normal hours of operation. Public facilities and improvements eligible for assistance under this paragraph are subject to the policies in 570.200(b) & (c). Multi-Use Building/Facility ( 570.200 (b) Special policies governing facilities.) A public facility otherwise eligible for assistance under the CDBG program may be provided with CDBG funds even if it is part of a multiple use building containing ineligible uses under the following conditions: The facility which is otherwise eligible and proposed for assistance must occupy a designated and discrete area within the larger facility; and The subrecipient can determine the costs attributable to the facility proposed for assistance as separate and distinct from the overall costs of the multiple-use building and/or facility. Allowable costs are limited to those attributable to the eligible portion of the building/facility. Reasonable fees may be charged for the use of the facilities assisted with CDBG funds, but charges such as excessive membership fees, which will have the effect of precluding low and moderate income persons from using the facilities, are not permitted. Special Assessments ( 570.200 (c)) Special Assessments are defined as the recovery of the capital costs of a public improvement through a fee or charge levied or filed as a lien against a parcel of real estate as a direct result of benefit derived from the installation of a public improvement, or a one-time charge made as a condition of access to a public improvement. Periodic charges based on the use of a public improvement, such as water or sewer user charges, even if such charges include the recovery of all or some portion of the capital costs of the public improvement are not considered to be special assessments. Where CDBG funds are used to pay all or part of the cost of a public improvement, special assessments may be imposed as follows: (1) Special assessments to recover the CDBG funds may be made only against properties owned and occupied by persons not of low and moderate income. Such assessments constitute program income in accordance with 24 CFR 570.503(b)(3). (Refer to Section 7 Other Program Requirements.) (2) Special assessments to recover the non-cdbg portion may be made provided that CDBG funds are used to pay the special assessment in behalf of all properties owned and occupied by low and moderate income persons; except that CDBG funds need not be used to pay the special assessments in behalf of properties owned and occupied by moderate income persons if the grant recipient certifies that it does not have sufficient CDBG funds to pay the assessments in behalf of all of the low and moderate income owner-occupant persons. Funds collected through such special assessments are not program income. Section IV ELIGIBLE ACTIVITIES Page 4-3

Application Submission Information 1. Project Description a. (i) Provide a detailed project profile. Check the appropriate box to indicate the category of eligible activity. Refer to the descriptions below for eligible categories. PI-01 Street Improvements Installation or repair of streets, street drains, storm drains, curbs and gutters, tunnels, bridges, and traffic lights/signs. Also use PI-01: for improvements that include landscaping, street lighting, and/or street signs (commonly referred to as streetscaping ). if sidewalk improvements (see code PI-02) are part of more extensive street improvements. PI-02 Sidewalks Improvements Construction or reconstruction of sidewalks. Use PI-02 for sidewalk improvements that include the installation of trash receptacles, lighting, benches, and trees. Also use PI-02 for curb ramp installations in low-and-moderate-income service areas that are primarily residential. PI-03 Water/Sewer Improvements Installation or replacement of water lines, sanitary sewers, storm sewers, and fire hydrants. Costs of street repairs (usually repaving) made necessary by water/sewer improvement activities are included under PI-03. (For water/sewer improvements that are part of: more extensive street improvements, use PI-01 (assign PI-01, for example, to an activity that involves paving six blocks of Main Street and installing 100 feet of new water lines in one of those blocks). (For construction or rehabilitation of flood drainage facilities, use PI-05.) PI 04 Parks, Recreational Facilities Development of open space areas or facilities intended primarily for recreational use. PI-05 Flood Drainage Improvements Acquisition, construction, or rehabilitation of flood drainage facilities, such as retention ponds or catch basins. Do not use PI-05 for construction/rehabilitation of storm sewers, street drains, or storm drains. (Use PI-03 for storm sewers and PI-01 for street and storm drains.) PI-06 Neighborhood Facilities Acquisition, construction, or rehabilitation of facilities that are principally designed to serve a neighborhood and that will be used for social services or for multiple purposes (including recreation). Such facilities may include libraries and community centers. PI-07 Parking Facilities Acquisition, Construction, or rehabilitation of parking lots and parking garages. Also use PI-07 if the primary purpose of rehabilitating a public facility or carrying out a street improvement activity is to improve parking. (If parking improvements are only part of a larger street improvement activity, use PI-01.) Other Public Improvements Consult with the staff of the Office of Housing and Community Development regarding other eligible public improvements. (ii) Check the appropriate box to indicate if the facility or improvement is new or existing. (iii) Check the appropriate box to indicate if a change of size or capacity of the facility by >20%. (iv) Check the appropriate box to indicate if the project will change the land use. (v) Provide a detailed description of the public facility or improvement to be made, including and indication of new materials, dimensions, and quantities, and as applicable, existing materials, dimensions, and quantities. (vi) Describe any existing buildings and site improvements that comprise the facility. (vii) Indicate whether or not your organization owns the building. Section IV ELIGIBLE ACTIVITIES Page 4-4

(viii) Indicate if you currently lease or will be leasing space in the building to a tenant. (ix) State the current land use. (x) Indicate the year of construction of the building. b. (i) Indicate the primary function of the facility. Indicate programs or services provided. (ii) Indicate if the facility is part of a multi-use building. (Refer to discussion of multi-use building above.) c. (i) Indicate if any construction work or related activities have already been initiated. (ii) Indicate if the activity requires special permits, reviews, or local approvals. If permits, etc. are required, identify the permit and the jurisdictional agency. (iii) Indicate if a design professional has been engaged to develop project specifications and a cost estimate. (iv) Indicate if federal prevailing wages pursuant to the Davis Bacon Act have been factored into the cost estimate. Prevailing wages under the Davis Bacon Act are applicable to the project if the estimated cost exceeds $2,500. All construction work related in time, place, and purpose is subject to the federal wage requirements. (v) Complete the 2018 Detailed Project Cost Form and include with your application submission. (vi) Discuss how this project would proceed without the support of County CDBG funding. (vii) Indicate if you will levy special assessments to recover the cost of improvements. (Refer to discussion of special assessments above.) (viii) Indicate whether or not the proposed activity relates to a phased approach or master plan to provide or improve the infrastructure or facility in the same neighborhood or geographic area. As applicable, attach a detailed description of the scope of work for the entire project that identifies the individual component phases, the project schedule and sequencing, and the financial plan for supporting all costs of the comprehensive improvements. 2. Project Location a. (i through v) Identify the exact geographic location of the facility or improvements. Indicate the property address and nearest intersecting street, or indicate limits of proposed work (e.g. Main St. between 1st Ave. and 3rd Ave.) Indicate in what congressional district, census tract and block group the activity is located. Provide a USGS 7.5 minute quadrangle map indicating the exact location of the project. b. Indicate if the public improvement is located in or will have any impact on the following: (i) National Register Historic District (ii) 100 Year Floodplain (iii) Designated Wetlands Area c. Discuss how the proposed activity relates to any long-range acquisition program, and / or temporary easements by purchase or leasing that would be subject to the Uniform Relocation Act. d. (i) Indicate whether or not facility / improvement is located in any jurisdictions that have opted out of the County CDBG program. (ii) If the facility / improvements are located in a jurisdiction that has opted out of the County CDBG program, discuss how your facility / program will serve clients in all parts of Montgomery County. e. Indicate if the public facilities in your community conform to Uniform Federal Accessibility Standards (UFAS) (appendix A to 41 CFR part 101-19, subpart 101-19.6, for general type buildings) as required by the Architectural Barriers Act of 1968 and the Americans with Disabilities Act of 1990. If one or more of your public facilities are not compliant, you must state your plan for accommodating disabled persons from these facilities. Section IV ELIGIBLE ACTIVITIES Page 4-5

3. Project Benefit a. (i) Define the geographic area that is served by the facilities to be provided or improved by identifying the physical features (e.g. roads, railroad lines, creeks, etc.) that delineate the area. List each physical feature that serves as a boundary on the individual lines provided, adding lines as needed. Additionally, you must attach a map that depicts the boundaries of the service area. (ii) Provide documentation that the service area of the facility is primarily residential. Indicate the total number of properties/parcels located in the service area (iii) If area is determined to be blighted, describe boundaries of blighted area Attach map that indicates boundaries of designated blight area b. (i) Describe the existing physical problems or conditions to be corrected and discuss how residents of this area are impacted OR (ii) If area is determined to be blighted, describe the existing physical conditions of slum or blight. c. (i) Discuss how the proposed activity will correct these conditions OR (ii) If area is determined to be blighted, discuss how the activity will address one or more of the conditions which contributed to the deterioration of the area. d. Indicate whether or not the proposed activity relates to and contributes to the feasibility of development of affordable housing, particularly outside of racial, ethnic and low/moderate income concentration OTHER PROGRAM REQUIREMENTS - Please note that these requirements need to be addressed if the public improvement activity is funded. See Section VII for complete details. 570.503 (b)(8) Reversion of Assets. 570.602 Section 109 of the Act. --Non-discrimination 570.603 Labor Standards 570.604 Environmental Standards 570.605 National Flood Insurance Program 570.607 Employment and Contracting Opportunities 570.609 Use of Debarred, Suspended or Ineligible Contractors or Subrecipients 570.611 Conflict of Interest 570.614 Architectural Barriers Act and the Americans with Disabilities Act Section IV ELIGIBLE ACTIVITIES Page 4-6

Section IV ELIGIBLE ACTIVITIES Public Facilities Acquisition, construction, reconstruction, rehabilitation or installation of public facilities carried out by public or private nonprofit entities. Public Facilities Include but are not limited to shelters for the homeless, convalescent homes; hospitals; nursing homes; battered spouse shelters; halfway houses for run-away children, drug offenders or parolees; group homes for mentally disabled persons, and temporary housing for disaster victims. In undertaking such activities, design features and improvements which promote energy efficiency may be included. Such activities may also include the execution of architectural design features, and similar treatments intended to enhance the aesthetic quality of facilities and improvements receiving CDBG assistance, such as decorative pavements, railings, sculptures, pools of water and fountains, and other works of art. Facilities designed for use in providing shelter for persons having special needs are considered public facilities and not subject to the prohibition of new housing construction. When facilities are owned by nonprofit entities, they shall be operated so as to be open for use by the general public during all normal hours of operation. Facilities containing both eligible and ineligible uses are subject to special policies under 570.200 (b). See the discussion/description below on the provisions of this policy. Public Facilities may also be subject to special policies under 570.200 (c). See discussion/description of these special policies under Public Improvements above. Multi-Use Building/Facility ( 570.200 (b)) A public facility otherwise eligible for assistance under the CDBG program may be provided with CDBG funds even if it is part of a multiple use building containing ineligible uses under the following conditions: The facility which is otherwise eligible and proposed for assistance must occupy a designated and discrete area within the larger facility; and The subrecipient can determine the costs attributable to the facility proposed for assistance as separate and distinct from the overall costs of the multiple-use building/facility. Allowable costs are limited to those attributable to the eligible portion of the building/facility. Reasonable fees may be charged for the use of the facilities assisted with CDBG funds, but charges such as excessive membership fees, which will have the effect of precluding low and moderate income persons from using the facilities, are not permitted. Application Submission Information 1. Project Description a. (i) Provide a detailed project profile. Check the appropriate box to indicate the category of eligible activity. Refer to the descriptions below for eligible categories. PF-01 Neighborhood Facilities Acquisition, construction, or rehabilitation of facilities that are principally designed to serve a neighborhood and that will be used for social services or for multiple purposes (including recreation). Such facilities may include libraries and community centers. PF-02 Senior Centers Acquisition, construction, or rehabilitation of facilities (except permanent housing) for seniors. PF- 02 may be used for a facility serving both the elderly and the handicapped provided it is not intended primarily to serve persons with handicaps. If it is, use PF-03 Handicapped Centers instead. PF-03 Handicapped Centers Acquisition, construction, or rehabilitation of centers, group homes, and other facilities (except Section IV ELIGIBLE ACTIVITIES Page 4-7

permanent housing) for the handicapped. PF-03 may be used for a facility serving both the handicapped and the elderly provided it is not intended primarily to serve the elderly. If it is, use PF-02 instead. PF-04 Health Facilities Acquisition, construction, or rehabilitation of physical or mental health facilities. Examples of such facilities include neighborhood clinics, hospitals, nursing homes, and convalescent homes. PF-05 Youth Centers Acquisition, construction, or rehabilitation of facilities intended primarily for young people age 13 to 19. These include playground and recreational facilities that are part of a youth center. For the acquisition, construction or rehabilitation of facilities intended primarily for children age 12 and under, use PF-06. PF-06 Child Care Centers Acquisition, construction, or rehabilitation of facilities intended primarily for children age 12 and under. Examples are daycare centers and Head Start preschool centers. For the construction or rehabilitation of facilities for teenagers, use PF-05. PF-07 Homeless Facilities (not operating costs) Acquisition, construction, or rehabilitation of temporary shelters and transitional housing for the homeless, including battered spouses, disaster victims, runaway children, drug offenders, and parolees. Other Public Facilities Consult with the staff of the Office of Housing and Community Development regarding other eligible public facilities. (ii) Check the appropriate box to indicate if the public facility is new or existing. (iii) Check the appropriate box to indicate if a change of size or capacity of the facility by >20%. (iv) Check the appropriate box to indicate if the project will change the land use. (v) Provide a detailed description of the public facility or improvement to be made, including an indication of new materials, dimensions, and quantities, and as applicable, existing materials, dimensions, and quantities. (vi) Describe any existing buildings and site improvements that comprise the facility. (vii) Indicate whether or not your organization owns the building. (viii) Indicate if you currently lease or will be leasing space in the building to a tenant. (ix) State the current land use. (x) Indicate the year of construction of the building. b. (i) Indicate the primary function of the public facility(ies) to be provided or improved, and discuss the programs or services that are provided from the facility(ies). (ii) If the facility is part of a multi-use building, discuss how the proposed project will assist with improvement(s) to a designated and discrete area within the larger facility that is eligible for CDBG. (Refer to discussion of multi-use building above.) c. (i) Indicate if any construction work or related activities have already been initiated. (ii) Indicate if the activity requires special permits, reviews, or local approvals. If permits, etc. are required, identify the permit and the jurisdictional agency. (iii) Indicate if a design professional has been engaged to develop project specifications and a cost estimate. (iv) Indicate if federal prevailing wages pursuant to the Davis Bacon Act have been factored into the cost estimate. Prevailing wages under the Davis Bacon Act are applicable to the project if the estimated cost exceeds $2,500. All construction work related in time, place, and purpose is subject to the federal wage requirements. (v) Complete the 2018 Detailed Project Cost Form and include with your application submission. (vi) Discuss how this project would proceed without the support of County CDBG funding. (vii) Indicate if you will levy special assessments to recover the cost of improvements. (Refer to discussion of special assessments above.) (viii) Indicate whether or not the proposed activity relates to a phased approach or master plan to Section IV ELIGIBLE ACTIVITIES Page 4-8

provide or improve the infrastructure or facility in the same neighborhood or geographic area. As applicable, attach a detailed description of the scope of work for the entire project that identifies the individual component phases, the project schedule and sequencing, and the financial plan for supporting all costs of the comprehensive improvements. d. Discuss, as applicable, how the project relates to and contributes to the feasibility of the development of affordable housing, particularly outside of areas of racial, ethnic, and low/moderate income concentration. 2. Project Location a. (i) Identify the exact geographic location of the public facility(ies). Indicate the property address and nearest intersecting street, or indicate limits of proposed work (e.g. Main St. between 1st Ave. and 3rd Ave.). (ii) Describe any targeted geographic area of service related to the programs or services provided from the facility. Attach a USGS 7.5 minute quadrangle map indicating the exact location of the activity and any targeted service area. (iii through vi) In the spaces provided indicate the Congressional District, municipality, census tract, and census block group of the project location. b. Indicate if the facility is located in or will have any impact on the following: (i) National Register Historic District (ii) 100 Year Floodplain (iii) Designated Wetlands Area c. (i) Indicate whether or not facility / improvement is located in any of the jurisdictions that have opted out of the County CDBG program. (ii) If the facility / improvements are located in a jurisdiction that has opted out of the County CDBG program, discuss how your facility / program will serve clients in all parts of Montgomery County. You must discuss your agency s promotional strategies for making prospective clients in all parts of Montgomery County aware of the programs or services provided from the facility. And, you must demonstrate that your clients will be drawn primarily from the urban county, and that reasonable benefits from the activity will accrue to residents within the jurisdiction of the urban county. d. Indicate if the public facilities in your community conform to Uniform Federal Accessibility Standards (UFAS) (appendix A to 41 CFR part 101-19, subpart 101-19.6, for general type buildings) as required by the Architectural Barriers Act of 1968 and the Americans with Disabilities Act of 1990. If one or more of your public facilities are not compliant, you must state your plan for accommodating disabled persons from these facilities. 3. Project Benefit a. Discuss in detail and provide authoritative documentation for one of the following items which best fits your activity: (i) Provide documentation establishing that the public facility(ies) is designed for the particular needs of or used exclusively by abused children, battered spouses, elderly persons, adults meeting the Bureau of the Census' Current Population Reports definition of "severely disabled," homeless persons, illiterate adults, persons living with AIDS, or migrant farm workers, or (ii) Provide documentation of procedures to obtain information on family size and income so that it is evident that at least 51% of the clientele being served by the facility are persons whose family income does not exceed the low and moderate income limit, or (iii) Provide documentation that describes any income eligibility requirements which limit the programs or services provided from the facility exclusively to low and moderate income persons, Section IV ELIGIBLE ACTIVITIES Page 4-9

or (iv) Provide documentation that describes how the nature and, if applicable, the location of the facility establishes that it is used predominantly by low and moderate income persons. b. Projected number of clients served by this project. Provide the following data pertaining to income and race/ethnicity of the clients you served in the most recently completed 12 month period for which this data is available. (i) Indicate the total number of Moderate Income clients. Moderate income clients are in the 80% Median income category. (ii) Indicate the total number of Low Income Clients. Low Income clients are in the 50% Median income category. (iii) Indicate the total number of Extremely Low Income Clients. Extremely low-income clients are in the 30% Median income category. (iv) Total Other Clients (above 80% Median). Other clients whose incomes exceed the 80% Median income category. TOTAL Indicate the total number of clients served by adding the amounts indicated on lines b(i), b(ii), b(iii) and b(iv). b. Indicate the number of clients by race/ethnicity. For each racial category indicated (i x), provide the total number of clients who are members of that category in the corresponding block in the column labeled #Total. For each racial category indicated, provide in the column labeled #Hispanic the total number of clients who are members of that category and are also Hispanic. TOTAL Indicate the total number of clients served by adding the amounts indicated in the column labeled #Total for each racial category. Indicate the total number of Hispanic clients served by adding the amounts indicated in the column labeled #Hispanic for each racial category. d. Indicate the number of clients who are single-heads of household by providing in the row labeled Total the number of male and female single heads of household in their respective columns. OTHER PROGRAM REQUIREMENTS - Please note that these requirements will need to be addressed if the public facility activity is funded. See Sec. VII for complete details. 570.503 (b)(8) Reversion of Assets. 570.200 (j) Faith-based Activities 570.602 Section 109 of the Act. --Non-discrimination 570.603 Labor Standards 570.604 Environmental Standards 570.605 National Flood Insurance Program 570.607 Employment and Contracting Opportunities 570.609 Use of Debarred, Suspended or Ineligible Contractors or Subrecipients 570.611 Conflict of Interest Section IV ELIGIBLE ACTIVITIES Page 4-10

Section IV ELIGIBLE ACTIVITIES Public Services Provision of public services (including labor, supplies, and materials) including but not limited to those concerned with employment, crime prevention, child care, health, drug abuse, education, fair housing counseling, energy conservation, welfare (but excluding the provision of income payments), homebuyer downpayment assistance, or recreational needs. To be eligible for assistance, a public service must be either a new service, or a quantifiable increase in the level of an existing service above that which has been provided by or on behalf of the unit of general local government (through funds raised by the unit, or received by the unit from the State in which it is located) in the 12 calendar months before the submission of the action plan. (An exception to this requirement may be made if HUD determines that any decrease in the level of a service was the result of events not within the control of the unit of general local government.) Application Submission Information 1. Project Description a. Provide a detailed description of the services to be provided by the project. Describe when, how, and to whom each service will be provided and the frequency with which the service will be provided. Identify which staff positions will have a role in the delivery of the service. Attach staff position descriptions. Discuss how the proposed activity relates to a comprehensive plan to provide the service over an extended period of time, including financial support. b. Indicate the primary goals of the services to be provided and how the goals will be quantified, monitored and tracked. This must include the number of clients to be served, units/hours of service to be provided, and a quantifiable measurement of accomplishment for each service. c. Indicate whether the project is a new service not previously funded by the County, or a supplement to an existing service. If supplementing an existing service, discuss how the project will increase the level of service currently being provided. Indicate whether the activity is currently supported or was previously supported (in the 12 months prior to the application due date) with any other source of County funds. If so, explain and list sources. Discuss the status of those funds and why CDBG funds are now being sought. d. Discuss, as applicable, how your public services could relate to the feasibility of affordable housing to expand fair housing choice for LMI families and members of the protected classes particularly outside the existing areas of racial, ethnic, and low/moderate income concentration. 2. Project Location a. Indicate the location from where the services will be delivered (i.e. street address) and include a map that clearly identifies this location. Describe the targeted geographic area in which the service will be provided and include a map that clearly delineates the targeted area. b. Indicate the congressional district in which the facility is located. Indicate if the facility is located in or will have any impact on the following: (i) National Register Historic District (ii) 100 Year Floodplain (iii) Designated Wetlands Area c. Identify if the service is located in any of the following municipalities: Abington Township, Section IV ELIGIBLE ACTIVITIES Page 4-11

Conshohocken Borough, Limerick Township, Lower Merion Township, Marlborough Township, or Norristown Municipality. If the service is located in any one of these municipalities, you must discuss your agency s promotional strategies for making prospective clients in all parts of Montgomery County aware of the programs or services provided. How will you demonstrate that the clients are drawn from the urban county? 3. Project Benefit a.discuss in detail and provide authoritative documentation for one of the following items which best fits your project: (i) Provide documentation establishing that the service is designed for the particular needs of or used exclusively by abused children, battered spouses, elderly persons, adults meeting the Bureau of the Census' Current Population Reports definition of "severely disabled," homeless persons, persons living with AIDS, illiterate adults, or migrant farm workers, or (ii) Provide documentation of procedure to obtain information on family size and income so that it is evident that at least 51% of the clientele benefiting from the public service are persons whose family income does not exceed the low and moderate income limit. Submit a copy of the agency in-take forms that assist in making an income determination for clients served, or (iii) Provide documentation that describes any income eligibility requirements which limit the programs or services provided from the facility exclusively to low and moderate income persons, or (iv) Provide documentation which describes how the nature and, if applicable, the location of the service or facility establishes that it is used predominantly by low and moderate income persons. b. Projected number of clients served by this project Provide the following data pertaining to income and race/ethnicity of the clients you served in the most recently completed 12 month period for which this data is available. (i) Indicate the total number of Moderate Income clients. Moderate income clients are in the 80% Median income category. (ii) Indicate the total number of Low Income Clients. Low Income clients are in the 50% Median income category. (iii) Indicate the total number of Extremely Low Income Clients. Extremely low-income clients are in the 30% Median income category. (iv) Total Other Clients (above 80% Median). Other clients whose incomes exceed the 80% Median income category. TOTAL Indicate the total number of clients served by adding the amounts indicated on lines b (i), b(ii), b(iii), b(iv). c. Indicate the number of clients by race/ethnicity. For each racial category indicated, provide the total number of clients who are members of that category in the corresponding block in the column labeled #Total. For each racial category indicated, provide in the column labeled #Hispanic the total number of clients who are members of that category and are also Hispanic. TOTAL Indicate the total number of clients served by adding the amounts indicated in the column labeled #Total for each racial category. Indicate the total number of Hispanic clients served by adding the amounts indicated in the column labeled #Hispanic for each racial category. e. Indicated the number of clients who are single-heads of household by providing in the row labeled Total the number of male and female single heads of household in their respective columns. OTHER PROGRAM REQUIREMENTS - Please note that these requirements will need to be addressed if the public service activity is funded. Please see Sec. VII for complete details. Section IV ELIGIBLE ACTIVITIES Page 4-12

570.200 (j) Faith-based Activities 570.602 Section 109 of the Act. --Non-discrimination 570.604 Environmental Standards 570.607 Employment and Contracting Opportunities 570.609 Use of Debarred, Suspended or Ineligible Contractors or Subrecipients 570.611 Conflict of Interest 570.613 Eligibility restrictions for certain resident aliens Section IV ELIGIBLE ACTIVITIES Page 4-13

Section IV ELIGIBLE ACTIVITIES Housing Multi-Family Rehabilitation Provision to facilitate the rehabilitation of existing housing stock which is occupied by residents who are very low and low income to preserve housing stock. Application Submission Information 1. Project Description a. Provide a detailed physical description of the existing structure and improvements to be rehabilitated for residential purposes. Indicate the current permitted land use and date the building was constructed. Include in your discussion an identification of the after-rehabilitation use of the structure as single-family or multi-family; owner-occupied or tenant occupied; a mixed-use/multiuse structure (discuss types of uses involved); the height of building in terms of the number of stories; and the number of residential units in the structure; discuss the category of rehab e.g. for rental housing, group home, transitional housing, etc. b. Provide a detailed description of the rehabilitation work to be performed on the structure and improvements. Indicate if the proposed rehabilitation work will result in either the temporary or permanent displacement of an occupant(s) of one or more dwellings units in the structure. If displacement will occur, discuss your plan to provide relocation benefits and services to the occupant(s). Indicate if the proposed rehabilitation work will result in the elimination of any affordable housing units. Discuss, as applicable, the measure to be undertaken to comply with HUD Lead-based Paint requirements pursuant to 24 CFR Part 35. c. Provide a detailed cost estimate for the rehabilitation project identifying the total estimated cost and the portion of costs proposed to be supported with CDBG funding. Indicate whether the project will involve a change in the unit density by more than 20% or changes in land use from residential to non-residential. State whether the estimated cost of rehabilitation is less than 75 percent of the total estimated cost of replacement after rehabilitation. Discuss how the proposed rehabilitation work may be related to a master plan for capital improvement of the structure. d. Does the developer have a written agreement with an advocacy organization that agrees to target outreach, affirmative marketing and tracking to members of protected classes? Discuss this relationship. 2. Project Location a. Indicate the exact geographic location of the housing unit(s). Indicate the property address(es) and nearest intersecting street(s), or indicate limits of proposed work (e.g. Main Street between 1 st Avenue and 3 rd Avenue). Provide a map(s) indicating the exact location of the projects. NOTE: Housing units located in Abington Township, Conshohocken borough, Limerick Township, Lower Merion Township, Marlborough Township, or Norristown Municipality are not eligible for funding. b. Is the project located in a census tract outside the areas of racial, ethnic and LMI concentration? Discuss, as applicable, how the project relates to and contributes to the feasibility of the development of affordable housing, particularly outside of areas of racial, ethnic and low/moderate income concentration. Section IV ELIGIBLE ACTIVITIES Page 4-14

Indicate the congressional district, Municipality, Census Tract(s), and Census Block Group(s). Indicate if the housing unit(s) is/are located in or will have any impact on the following: (i) National Register Historic District (ii) 100 Year Floodplain (iii) Designated Wetlands Area 3. Project Benefit Discuss in detail and provide authoritative documentation for: a Provide documentation of procedures to obtain information on household size and income so that it is evident that at least 51% of the housing units being rehabilitated will be occupied by low and moderate income households upon completion of the rehabilitation. b. Provide a rent schedule that indicates the rent to be charged after rehabilitation for each dwelling unit in the structure, and show a comparison of these rents to HUD Fair Market Rents. c. Indicate whether five percent (5%) of the dwelling units in the structure are readily accessible to and usable by individuals with handicaps, or discuss how the rehabilitation of the structure will result in a minimum of 5% of the units be readily accessible to and usable by individuals with handicaps. Discuss the number of UFAS accessible units to be provided as a percentage of total units. 4. Projected number of households served by this project Provide the following data pertaining to income and race/ethnicity of the households you served in the most recently completed 12 month period for which this data is available. a. Indicate the total number of Moderate Income households. Moderate income households are in the 80% Median income category. b. Indicate the total number of Low Income Households. Low Income households are in the 50% Median income category. c. Indicate the total number of Extremely Low Income Households. Extremely low-income households are in the 30% Median income category. d. Total Other Households (above 80% Median). Other households whose incomes exceed the 80% Median income category. TOTAL Indicate the total number of households served by adding the amounts indicated on lines 4a.,4b.,4c. and 4d. e. Indicate the number of households by race/ethnicity. For each racial category indicated, provide the total number of households who are members of that category in the corresponding block in the column labeled #Total. For each racial category indicated, provide in the column labeled #Hispanic the total number of households who are members of that category and are also Hispanic. TOTAL Indicate the total number of households served by adding the amounts indicated in the column labeled #Total for each racial category. Indicate the total number of Hispanic households served by adding the amounts indicated in the column labeled #Hispanic for each racial category. f. Indicated the number of households who are single-head of household by providing in the row labeled Total the number of male and female single head of household in their respective Section IV ELIGIBLE ACTIVITIES Page 4-15

columns. OTHER PROGRAM REQUIREMENTS - Please note that these requirements will need to be addressed if the public service activity is funded. Please see Sec. VII for complete details. 570.200 (j) Faith-based Activities 570.602 Section 109 of the Act. --Non-discrimination 570.603 Labor Standards (these requirements apply to the rehabilitation of residential property only if such property contains not less than 8 units) 570.604 Environmental Standards 570.606 Displacement, relocation, acquisition, and replacement of housing 570.607 Employment and Contracting Opportunities 570.609 Use of Debarred, Suspended or Ineligible Contractors or Subrecipients 570.611 Conflict of Interest Section IV ELIGIBLE ACTIVITIES Page 4-16

Section IV ELIGIBLE ACTIVITIES Housing Single Family Rehabilitation Acquire for the purpose of rehabilitation, and rehabilitate privately owned buildings and improvements, for use or resale for permanent single-family residential purposes which, upon completion, will be occupied by low-and-moderate-income households. Improvements to a single-family residential property which is also used as a place of business, which are required in order to operate the business, need not be considered to be rehabilitation of a commercial or industrial building, if the improvements also provide general benefit to the residential occupants of the building Application Submission Information 1. Project Description a. Provide a detailed physical description of the existing structure and improvements to be rehabilitated for residential purposes. Indicate the current permitted land use and date the building was constructed. Include in your discussion an identification of the after-rehabilitation use of the structure as single-family owner-occupied, or type of occupancy e.g. elderly or special needs housing. b. Provide a detailed description of the rehabilitation work to be performed on the structure and improvements. Indicate if the proposed rehabilitation work will result in either the temporary or permanent displacement of an occupant(s) of one or more dwellings units in the structure. If displacement will occur, discuss your plan to provide relocation benefits and services to the occupant(s). Indicate if the proposed rehabilitation work will result in the elimination of any affordable housing units. Discuss, as applicable, the measure to be undertaken to comply with HUD Lead-based Paint requirements pursuant to 24 CFR Part 35. c. Provide a detailed cost estimate for the rehabilitation project identifying the total estimated cost and the portion of costs proposed to be supported with CDBG funding. Indicate whether the project will involve a change in the unit density by more than 20% or changes in land use from residential to non-residential. State whether the estimated cost of rehabilitation is less than 75 percent of the total estimated cost of replacement after rehabilitation. Discuss how the proposed rehabilitation work may be related to a master plan for capital improvement of the structure. 2. Project Location a. Indicate the exact geographic location of the housing unit(s). Indicate the property address(es) and nearest intersecting street(s), or indicate limits of proposed work (e.g. Main Street between 1 st Avenue and 3 rd Avenue). Provide a map(s) indicating the exact location of the projects. NOTE: Housing units located in Abington Township, Conshohocken borough, Limerick Township, Lower Merion Township, Marlborough Township, or Norristown Municipality are not eligible for funding. b. Is the project located in a census tract outside the areas of racial, ethnic and LMI concentration? Discuss, as applicable, how the project relates to and contributes to the feasibility of the development of affordable housing, particularly outside of areas of racial, ethnic and low/moderate income concentration. Indicate the congressional district, Municipality, Census Tract(s), and Census Block Group(s). Indicate if the housing unit(s) is/are located in or will have any impact on the following: Section IV ELIGIBLE ACTIVITIES Page 4-17

(i) National Register Historic District (ii) 100 Year Floodplain (iii) Designated Wetlands Area 3. Project Benefit Discuss in detail and provide authoritative documentation for: a Provide documentation of procedures to obtain information on household size and income so that it is evident that at least 51% of the housing units being rehabilitated will be occupied by low and moderate income households upon completion of the rehabilitation. b. Provide a rent schedule that indicates the rent to be charged after rehabilitation for each dwelling unit, and show a comparison of these rents to HUD Fair Market Rents. c. Indicate if the proposed rehabilitation work will result in any structures being readily accessible to and usable by individuals with disabilities. 4. Projected number of households served by this project Provide the following data pertaining to income and race/ethnicity of the households you served in the most recently completed 12 month period for which this data is available. g. Indicate the total number of Moderate Income households. Moderate income households are in the 80% Median income category. h. Indicate the total number of Low Income Households. Low Income households are in the 50% Median income category. i. Indicate the total number of Extremely Low Income Households. Extremely low-income households are in the 30% Median income category. j. Total Other Households (above 80% Median). Other households whose incomes exceed the 80% Median income category. TOTAL Indicate the total number of households served by adding the amounts indicated on lines 4a.,4b.,4c. and 4d. k. Indicate the number of households by race/ethnicity. For each racial category indicated, provide the total number of households who are members of that category in the corresponding block in the column labeled #Total. For each racial category indicated, provide in the column labeled #Hispanic the total number of households who are members of that category and are also Hispanic. TOTAL Indicate the total number of households served by adding the amounts indicated in the column labeled #Total for each racial category. Indicate the total number of Hispanic households served by adding the amounts indicated in the column labeled #Hispanic for each racial category. l. Indicated the number of households who are single-head of household by providing in the row labeled Total the number of male and female single head of household in their respective columns. OTHER PROGRAM REQUIREMENTS - Please note that these requirements will need to be addressed if the public service activity is funded. Please see Sec. VII for complete details. Section IV ELIGIBLE ACTIVITIES Page 4-18